Skinner C M, Rangasami J
Royal Berkshire Hospital, Reading, UK.
Br J Anaesth. 2002 Nov;89(5):792-5.
There has been recent concern in the media over the possible detrimental effects of herbal medicines on the perioperative period. Perceived by the public as 'natural' and therefore safe, herbal remedies may have led to adverse events such as myocardial infarction, bleeding, prolonged or inadequate anaesthesia and rejection of transplanted organs. In addition, herbal remedies can interact with many drugs given in the perioperative period. In this article we summarize the potential perioperative complications that can occur.
In order to determine the extent of use of herbal medicines, we conducted a survey of patients presenting for anaesthesia. During a 3-month period, patients were directly asked by anaesthetic staff if they were currently self-administering herbal medication.
Of 2723 patients, 131 (4.8%) were taking one or more herbal remedy. In only two cases was this recorded in the patients' notes. Women and patients aged 40-60 yr were most likely to be taking a herbal product (P<0.05 and P<0.001 respectively). The most commonly used compounds were, in descending order, garlic, ginseng, ginkgo, St John's wort and echinacea.
Self-administration of herbal medicines is common in patients presenting for anaesthesia. Because of the potential for side-effects and drug interactions it is important for anaesthetists to be aware of their use.
近期媒体对草药在围手术期可能产生的有害影响表示关注。草药被公众视为“天然”且因此安全，但可能导致心肌梗死、出血、麻醉时间延长或不足以及移植器官排斥等不良事件。此外，草药可与围手术期使用的许多药物发生相互作用。在本文中，我们总结了可能出现的潜在围手术期并发症。
为确定草药的使用程度，我们对接受麻醉的患者进行了一项调查。在3个月期间，麻醉工作人员直接询问患者是否正在自行服用草药。
在2723例患者中，131例（4.8%）正在服用一种或多种草药。只有两例在患者病历中有记录。女性和40至60岁的患者最有可能服用草药产品（分别为P<0.05和P<0.001）。最常用的草药成分按降序排列为大蒜、人参、银杏、圣约翰草和紫锥菊。
接受麻醉的患者自行服用草药的情况很常见。由于存在副作用和药物相互作用的可能性，麻醉医生了解其使用情况很重要。
